国产粒细胞集落刺激因子动员健康供者造血干细胞的临床观察

Clinical Observation on Mobilization of Healthy Donor Hematopoietic Stem Cells by Domestic Granulocyte Colony Stimulating Factor

目的:观察国产粒细胞集落刺激因子(G-CSF)对32名健康供者外周血造血干细胞动员效果及不良反应。方法:选取2017年4-11月期间32名健康供者应用G-CSF 5~10μg/(kg·d)连续5 d皮下注射,若第4天白细胞低于30×10~9/L,第4.5天开始采集前2 h加用G-CSF 5μg/kg皮下注射,用COBE Spectra血细胞分离机采集外周血造血干细胞,若采集数量不够,第5.5天再采集1次。观察供者动员前后血常规的变化和采集造血干细胞结果,以及出现的不良反应。结果:动员后第4.5天白细胞明显高于动员前,差异均有统计学意义(P<0.05)。32名供者均成功采集,外周血单个核细胞(PBMNC)8.5(3.17~20.95)×10~8/kg、CD34^+6.43(2.15~17.5)×10~6/kg,其中4名供者需采集2次,余28名供者均采集1次。10名供者出现腰背部酸痛,3名出现乏力,均能耐受;4名供者采集过程中出现口唇、四肢麻木,予静滴钙剂后均缓解。结论:所有供者经G-CSF动员后均可成功采集,并能耐受其不良反应,可替代进口G-CSF供临床使用。

Objective：To observe the mobilization and adverse effects of domestic granulocyte colony stimulating factor（G-CSF）on peripheral blood hematopoietic stem cells in 32 healthy donors.Method：A total of 32 healthy donors from April to November 2017 were selected for 5 consecutive days of subcutaneous injection of G-CSF 5-10 μg/（kg·d）.If white blood cells count were less than 30×10~9/L on day 4,subcutaneously injected with G-CSF for 5 μg/kg 2 hours before day 4.5.Peripheral blood hematopoietic stem cells were collected by a COBE Spectra blood cell separator,in the event that the quantity collected was not sufficient,an additional sample would be collected on day 5 and a half.The changes of blood routine before and after mobilization,the results of hematopoietic stem cells and the adverse reactions were observed.Result：White blood cells were significantly higher at 4.5 days after mobilization than those before mobilization, the differences were statistically significant（P〈0.05）.All 32 donors were successfully collected,PBMNC were 8.5（3.17-20.95）×108/kg,CD34＋ were 6.43（2.15-17.5）×106/kg,of which 4 donors required additional collection,with the rest needing only the initial collection.10 donors experienced lumber and back pain and 3 donors reported fatigue,both of which were tolerable.Lip and limb numbness were observed in 4 donors,who were given intravenous calcium.Conclusion：All donors are able to successfully collection after mobilization by G-CSF and can tolerable adverse reactions,which can replace imported G-CSF for clinical use.